It is probably no coincidence that city officials chose a
public health clinic as the site for the official signing of legislation
implementing San Francisco's Health Access Plan on Monday, August 7. A large
percentage of the clients who visit the tiny Southeast Health Clinic nestled in
the Bayview-Hunter's Point area, one of the city's poorest neighborhoods,
ultimately stand to benefit from HAP, designed to provide healthcare access to
all San Franciscans.

"San Francisco is the first city in the nation to
provide universal healthcare access to the uninsured," Mayor Gavin Newsom
said prior to signing the ordinance at a news conference held outside of the
health clinic.

"We have created a plan that will allow for every San
Franciscan to have access to ongoing primary and preventive healthcare. I am
proud of the commitment demonstrated by Supervisor [Tom] Ammiano, as well as
San Francisco's healthcare, business, labor, advocacy and philanthropic
communities in helping us create this plan and legislation," Newsom said.

The ordinance is the culmination of Newsom's pledge to
provide access to healthcare for the city's estimated 82,000 uninsured.
Ammiano, who sponsored legislation that in part funds HAP, including mandated
fees on businesses, joined the mayor at the signing ceremony.

"This is a very important first step," Ammiano
said. "San Francisco has already been contacted by a number of other
cities, including Chicago, who all want to know about this."

Ammiano praised the supervisors' support of the plan.

"With the passage of the San Francisco Health Care
Security Ordinance by a unanimous vote by the Board of Supervisors –
which is unheard of I might say – our city sends a strong message to
state and local governments across this nation. The message is that when the
community speaks up, and the political will is there – no problem is too
great. Even the question of universal health care can be surmounted," said
Ammiano.

Newsom also announced the formation of a 19-member HAP
advisory council to oversee and shape the defined benefits of the program.
Modeled after the recommendations of the city's Universal Healthcare Council,
advisers and officials will now work to provide consultation to the Department
of Public Health for design and implementation of the program.

That includes setting membership rates, designing the range
of benefits and health care services, researching utilization and costs and
evaluation of the program, including areas of improvement.

"This committee is ready to go to work," said
Catholic Healthcare West CEO Lloyd Dean, who with Health Director Dr. Mitch
Katz will co-chair the advisory council.

"This legislation is so very significant and so very
important. It is inspiring to stand here in front of this building and tell the
public that we are ready to take this dream that the mayor and Supervisor
Ammiano have had and make it into a reality," Dean said.

The ordinance takes effect in January and city officials
expect to see the program's first enrollees by July 2007.

"We anticipate the first 15,000 enrollees by that
time," said David Grant, director of health policy at Senior Action
Network and member of the advisory committee. "Before that time we will be
talking about what computer software we will be needing and methods to enroll
and educate the participants."

"This next phase will be the most complex," Newsom
said of HAP's implementation. "We don't want to over promise and under
deliver. San Francisco has come up with a lot of great ideas in the past and we
want to know this plan is going to be no exception."

Some city business owners say they will be hard-pressed to
make the co-payments necessary to help fund HAP, as outlined by Ammiano's
legislation, and there has been some talk of possible litigation against the
plan's implementation.

"We may see some litigation, but I do not foresee it
stalling HAP getting off the ground," Newsom told reporters after signing
the bill. "We are all in this together and rightfully so," he said.

Newsom was quick to point out that of the expected $198
million price tag on HAP, only about $28 million will be coming from the
mandated fees on businesses. A total of $160 million will be covered by the
city while the balance will be funded by enrollees' co-payments.

San Francisco Labor Council Executive Director Tim Paulson,
who also attended the event, issued a statement backing the legislation.

"Workers and residents of San Francisco won a major
victory today when Mayor Newsom signed the San Francisco Health Care Security
Ordinance," he said in a statement. "For over a year, the San
Francisco Labor Council and major community groups, including Senior Action
Network, ACORN, Bay Area Organizing Committee, Healthcare for All, and Young
Workers United, have been working with Supervisor Tom Ammiano to pass
meaningful healthcare reform for the city of San Francisco. Today, our hard
work is realized."

Paulson said the spending requirement is not only a critical
funding source for the program, but also levels the playing field for the majority
of San Francisco employers already providing health benefits to their
employees.

"The Health Care Security Ordinance ensures all members
of the community – government, employers, and individuals –
contribute fairly to create a healthier community. Everybody deserves quality
healthcare. Workers without health coverage are just one accident or illness
away from poverty and unemployment. San Francisco is choosing to act rather
than stand by and wait while the federal government fails to address the health
care crisis in this county," Paulson said.

The HAP advisory council meets for the first time on August
25 and plans on having a Web site providing information on the plan up and
running by September 1.

Once up and running, HAP is expected to provide access to
medical home and primary care physicians, allowing a greater focus on
preventive care, as well as specialty care, urgent and emergency care,
laboratory, inpatient hospitalization, radiology and pharmaceuticals. It will
be administered by the San Francisco Health Plan, the city-sponsored program
that currently provides care for 50,000 city residents.

All San Franciscans are eligible for the program regardless
of employment or immigration status. In order to join HAP, an individual must
be uninsured, live in San Francisco, and be willing to apply for state and
federal health benefits. Primary care and specialist physicians, clinics, and
hospitals that currently comprise the city health network will deliver the
services.